Knee Conditions
Diagnostic Codes 5256–5261 • 38 CFR § 4.71a
Separate ratings are often allowed on the same knee (flexion, extension, instability)—not pyramiding when distinct functional losses are shown.
DC range
5256–61
Knee Ratings at a Glance (2026, veteran alone)
Examples below use common DCs—5260 flexion, 5261 extension, and knee instability under DC 5257. Your decision may list different codes for meniscus, ankylosis, or replacement residuals.
Flexion limited to 15° (DC 5260)
$552.47/mo
Flexion limited to 30°
$356.66/mo
Flexion limited to 45°
$180.42/mo
Flexion limited to 60°
$0 schedular under DC 5260
Instability (DC 5257) — criteria depend on diagnosis, prescribed treatment, and assistive devices
See DC 5257
Extension limitation (5261) by angle
$180.42–$1,132.90/mo
Bilateral factor: When each knee has a compensable (10% or more) rating, VA combines those ratings, then adds 10 percent of that combined value (§ 4.26), unless leaving one knee out produces a higher evaluation (§ 4.26(d)). Checked October 7, 2026.
Complete regulatory criteria, CFR citations, and official rating notes for knee conditions
Three Compensation Scenarios
Stacked ratings — one knee
Illustration only: separate evaluations may be available for flexion, extension, and instability when each has distinct, supported manifestations and the anti-pyramiding rule is satisfied.
VA combines supported evaluations using VA math and applies the bilateral factor when its requirements are met. Confirm the diagnostic codes and effective-date rules for the individual decision.
Bilateral knees
Example: 20% right knee + 20% left knee + bilateral factor.
Combined + bilateral
40%
Monthly (veteran alone)
$795.84/mo
Official VA combined method: 20 then 20 = 36; +10% bilateral factor (3.6) = 39.6 → 40%. Veteran-alone 40% is $795.84 only.
Knee + spine + mental health
Combined often reaches 70–90% territory depending on exact percentages—use the Rating Calculator.
Evidence Requirements
Goniometer ROM
Separate measurements for flexion and extension; stop at pain.
Stability testing
Drawer/Lachman/varus-valgus stress—positive findings support 5257 when documented.
Imaging & surgical notes
MRI for meniscus/ACL; operative reports if applicable.
Bracing / assistive devices
Prescriptions for hinged braces, cane, or PT restrictions.
Lay statements
Buckling, swelling after activity, inability to kneel or run.
Common Secondary Conditions
🦵 Opposite knee
Commonly discussed5260 • Compensatory loading
🦴 Hip strain
Commonly discussed5252 • Gait change from knee pain
🫳 Lumbar strain
Commonly discussed5237 • Limping and pelvic tilt
🦶 Ankle strain
Sometimes discussed5271 • Altered weight-bearing
🧠 Depression
Sometimes discussed9434 • Chronic pain / mobility loss
⚙️ TKR residuals
Commonly discussed5055 • 4 months then residuals (min 30 total replacement)
Claim Timeline
Gather evidence
STR, imaging, PT notes, brace prescriptions
File 526EZ
Claim each knee separately if needed; list instability
C&P orthopedics
Confirm flexion, extension, and stability tests
Decision
Check for missing stacked ratings
Secondaries
Hip, back, opposite knee, depression as supported
What Gets You Higher Ratings
10% → 20–30%
Show flexion at or below 45°/30° or document extension deficit with measured angles—not estimates.
Add instability
If ligaments are loose and the knee gives way, a separate 5257 evaluation may apply on top of ROM.
Both knees
If both knees are service-connected and each is compensable, § 4.26 may apply, subject to § 4.26(d).
Common Mistakes
Only one rating for one knee
Miss flexion + extension + instability when each is supported.
No instability exam
If you report buckling, the exam should address ligament tests.
Ignoring bilateral factor
If both knees are service-connected and each is compensable, § 4.26 can apply, subject to the § 4.26(d) exception.
TKR timing
Official DC 5055 is 100% for 4 months following implantation, then residuals (minimum 30 total replacement only).
FAQs
▸ Can I get three ratings on one knee?
Often yes—when the evidence shows distinct limitation of flexion, limitation of extension, and instability without improper pyramiding. Final codes are fact-specific.
▸ How does the bilateral factor work?
After combining the two knee ratings with the § 4.25 table, VA adds 10 percent of that combined value (§ 4.26). That is not the same as adding the two ratings together. Section 4.26(d) can exclude the factor when leaving a disability out produces a higher evaluation. Checked October 7, 2026.
▸ What about knee replacement?
Official DC 5055: 100% for 4 months following implantation of prosthesis or resurfacing, then residuals. Minimum evaluation, total replacement only, is 30%. See 38 CFR § 4.71a.
DC Reference & Tools
Official criteria (selected)
Official VA rating criteria — Knee (selected codes)
Live 38 CFR § 4.71a rows (current as of 8/27/2026). DC 5260 is flexion. DC 5257 is recurrent subluxation or instability (ligament-tear / assistive-device language) and a separate patellar-instability ladder. It is not slight / moderate / severe / marked.
| Rating | VA criteria (eCFR text) | Schedule note |
|---|---|---|
| 30% (5260) | Flexion limited to 15°. | DC 5260 only. |
| 20% (5260) | Flexion limited to 30°. | DC 5260 only. Flexion limited to 45° is 10%, not 20%. |
| 10% (5260) | Flexion limited to 45°. | DC 5260 only. Flexion limited to 60° is 0%. |
| 0% (5260) | Flexion limited to 60°. | Official 5260 0% row. |
| 30% (5257) | Recurrent subluxation or instability: Unrepaired or failed repair of complete ligament tear causing persistent instability, and a medical provider prescribes both an assistive device (e.g., cane(s), crutch(es), walker) and bracing for ambulation. | Not “marked / frequent giving out.” |
| 20% (5257) | One of the following: (a) Sprain, incomplete ligament tear, or repaired complete ligament tear causing persistent instability, and a medical provider prescribes a brace and/or assistive device (e.g., cane(s), crutch(es), walker) for ambulation. (b) Unrepaired or failed repair of complete ligament tear causing persistent instability, and a medical provider prescribes either an assistive device (e.g., cane(s), crutch(es), walker) or bracing for ambulation. | 38 CFR § 4.71a DC 5257. |
| 10% (5257) | Sprain, incomplete ligament tear, or complete ligament tear (repaired, unrepaired, or failed repair) causing persistent instability, without a prescription from a medical provider for an assistive device (e.g., cane(s), crutch(es), walker) or bracing for ambulation. | Patellar instability is a separate 30/20/10 ladder in the same code. |
Source: 38 CFR § 4.71a — https://www.ecfr.gov/current/title-38/chapter-I/part-4/subpart-B/subject-group-ECFRd3005f7d828ea7b/section-4.71a (current as of 8/27/2026).
⚠️ Important Disclaimer
This page provides general educational information based on public VA regulations and VA.gov resources. It is not legal or medical advice, and My Claim Packet is not a VA-accredited representative. Any worksheets or draft documents produced by the tools must be reviewed for accuracy and are not filed with VA for you. Ratings and service connection are decided case-by-case from the individual record. Consult a VA-accredited VSO, claims agent, attorney, or qualified clinician for help with your situation, and verify current rules using the linked official source.